After an orthopaedic hand surgery, one of the doctor’s primary goals would be to make sure there is minimal post-operative pain.
While some discomfort may be expected, it is reassuring to know that advancements in pain control has made management of pain relatively easier nowadays.
There are many kinds of medications available designed to manage pain including opioids, local anesthetics, and nonsteroidal anti-inflammatory drugs or NSAIDs.
Aside from minimizing the ache, pain medications can also make patients feel a lot more comfortable.
The comfort can often help the body recover and heal faster from the procedure.
If pain experienced is minimal, patient can start moving sooner and can also regain strength faster.
Some of the possible medications that will be given to manage pain after orthopaedic hand surgery include:
Opioid Analgesics
When treating pain that is moderate to severe, opioids are considered very effective.
It is also given to manage short-term post-surgery aches.
Considered among the world’s oldest drugs, natural opioids are made from the dried “milk” of the opium poppy plant.
Semi-synthetic and synthetic opioids are artificially manufactured in laboratories.
Regardless if natural or synthetic, opioids work by attaching themselves to opioid receptors that are found in the body like the brain, gastrointestinal tract, and the spinal cord and blocking the pain transmissions.
Opioids can be given to patients through different means—by mouth, under the tongue, directly into the bloodstream, and through the skin.
Opioids have been known to work really fast and can provide patients with the luxury to be able to get more rest at night and become more active during the day.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs are given to manage both mild and moderate pain.
However, when managing moderate to severe post-surgery pain, NSAIDs are often used together with opioids.
NSAIDs are often given to reduce the pain and the swelling.
It works by preventing the body from creating too much prostaglandin.
Some of the most common NSAIDs given include ibuprofen, aspirin, and naproxen.
While NSAIDs are known to have lesser side effects as opposed to opioids, it cannot relieve moderate to severe post-surgery pain when utilized alone.
Centrally Acting Non-Opioids
Tramadol
Tramadol is a synthetic opioid.
It was modeled after codeine, a more popular opioid.
Tramadol changes the way the body perceives pain and it accomplishes the task by interfering with the regulation of serotonin and norepinephrine.
When production of those chemicals are altered, it becomes more difficult for pain messages to be transmitted from a nerve cell to another.
While considered effective in managing moderate pain, it is more effective when used with NSAIDs or acetaminophen.
Acetaminophen
Acetaminophen, just like NSAIDs are usually used after surgery in order to reduce the use of opioid medications that are stronger.
Acetaminophen is believed to be effective in easing mild to moderate pain since it elevates the body’s pain threshold.
However, even if it is effective for headaches, fevers, and pain, it does not eliminate the inflammation and swelling.
Local Anesthetics
Local anesthetics function by blocking pain.
In orthopedic procedures, they are used during and post-surgery as part of after surgery management of pain.
To ease pain, local anesthetics work by blocking the pain signals that are being transmitted to the brain.
Some of the most commonly used anesthetics include bupivacaine, lidocaine, and ropivacaine.
While local anesthetics do not have side effects associated with opioid medications (i.e. breathing problems, drowsiness, and constipation), it also has certain risks like allergic reaction and even possible nerve damage.
Regional Anesthetics
Regional anesthetics act as anesthesia during surgery.
It also offers pain relief after the procedure.
Regional anesthetics work by blocking movement in the lower part of the body (spinal, epidural), one of the arms (axillary, intra-scalene, supraclavicular), and the legs (femoral, sciatic).
For more information on orthopaedic hand surgery, please visit www.bjios.sg.